Keratocyte

In some (although not all) cases, the pathological process may be life threatening particularly if they are associated with disseminated intravascular coagulation (DIC) or thrombotic thrombocytopenic purpura (TTP) knowledge of platelet count, clotting and additional morphological features such as fragments is essential.

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Microvascular damage

Disseminated intravascular coagulation (DIC), Thrombotic thrombocytopenic purpura (TTP), Renal disease particularly vasculitis, Disseminated malignancy

Physical trauma

Particularly defective prosthetic heart valve or valve disease with turbulent flow

Red cell fragility

e.g. iron deficiency, thalassemia, megaloblastic anemia, MDS (look for associated features)

Removal of denatured hemoglobin

oxidant damage (see also blister cells), Alpha thalassemia The cell must display 2 hooks or points

Less commonly

Small numbers may occur in liver disease and splenectomy